Prevention of acute gastrointestinal complications after severe head injury: A controlled trial of cimetidine prophylaxis

Halloran, L G; Zfass, Alvin M.; Gayle, William E.; Wheeler, Clara Belle; Miller, James

doi:10.1016/0002-9610(80)90228-7

Cited by 159 publications

(64 citation statements)

References 14 publications

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“…In the study period, 16 612 patients with ischemic or hemorrhagic strokes were admitted to the hospital or developed in-hospital stroke; therefore, our study patients represent 0.1% of the total population. Of the 17 patients with gastrointestinal hemorrhage, 14 patients had a CT scan-documented ischemic stroke (lacuna [1 patient]; middle cerebral artery upper or lower division [7]; middle cerebral artery stem [3]; posterior cerebral artery territory [1]; and basilar artery territory [2]). An intracerebral hemorrhage was seen in 3 patients (putamen [1] and subdural localization [2]).…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal bleeding in stroke.

Wijdicks

Fulgham

Batts

1994

Stroke

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Background and Purpose Patients-with ischemic or hemorrhagic stroke are at risk for systemic complications. The reasons why gastrointestinal bleeding occurs after stroke are unknown and have intuitively been attributed to stress ulcers. No study to date has addressed causes of gastrointestinal hemorrhage in stroke.Methods Between 1976 and 1994, 17 patients identified from the Mayo Clinic medical record system as having gastrointestinal hemorrhage and ischemic stroke (n=14) or intracerebral hemorrhage (n=3) were reviewed for presentation, associated causes, and outcome. Results of the endoscopic procedures were compiled, and available gastric biopsies were reviewed.Results In 17 patients with gastrointestinal bleeding after stroke, sudden hematemesis, a decrease in hemoglobin level, or orthostatic hypotension was found as a presenting feature.

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Section: Resultsmentioning

confidence: 99%

Gastrointestinal bleeding in stroke.

Wijdicks

Fulgham

Batts

1994

Stroke

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“…Peptic ulcer in children is usually of the secondary type such as stress ulcer in early infancy, but with older children it tends to be the primary type, which has been associated with histologic evidence of chronic active antral gastritis. 2,3 The presentation varies with age; it can present with massive brisk bleeding in early infancy and toddlers present with decreased appetite and poor feeding. 4 The usual presentation beyond the toddler age is abdominal pain, but gastric outlet obstruction in the form of projectile vomiting or hematemesis has been documented.…”

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confidence: 99%

“…Family history is positive between 20% and 63% of the cases. 3,6 Helicobacter pylori has been recently discovered to be associated with the peptic disease in childhood. 7,8 Eradication of H. pylori in addition to the use of antacids or H 2 blockers is associated with sustained healing of the peptic ulcer.…”

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confidence: 99%

Peptic Disease in Childhood in Asir Province

Telmesani

1994

Annals of Saudi Medicine

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“…Cimetidine has been shown to be of benefit in the prevention of GI haemor rhage in patients suffering from head injury [9,10], fulminant hepatic encephalopathy [11] and in patients following renal trans plantation [12,13]. Conversely cimetidine has failed to demonstrate a therapeutic effect in patients up to 6 months after renal trans plantation [14] and in patients with respira tory insufficiency [15], Several studies have compared the effects of cimetidine with antacid treatment.…”

Section: Discussionmentioning

confidence: 99%

A Double-Blind Randomized, Controlled Study to Investigate the Efficacy of Cimetidine Given in Addition to Conventional Therapy in the Prevention of Stress Ulceration and Haemorrhage in Patients with Acute Spinal Injury

et al. 1984

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The efficacy of cimetidine, 1.2 and 2.4g/day, compared to placebo treatment given in addition to conventional therapy, which included antacids, in the prevention of gastroduodenal lesions associated with stress in 105 patients with acute spinal injury was investigated. Haematemesis was only observed in 1 placebo-treated patient. Of the 84 patients who completed the 10-day treatment and underwent endoscopy, 12 out of 43 cimetidine-treated patients and 11 out of 41 patients who received placebo were found to have gastroduodenal ulceration and/or erosions. Mean circulating concentrations of gastrin, pancreatic polypeptide and secretin were similar in all groups of patients. Whilst cimetidine has been shown to reduce the incidence of ulceration in patients suffering cranial and thermal injuries, the present study failed to demonstrate a prophylactic effect of cimetidine in the primary prevention of ulcers or erosions in patients with acute spinal injury exceeding that of conventional antacid therapy.

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Prevention of acute gastrointestinal complications after severe head injury: A controlled trial of cimetidine prophylaxis

Cited by 159 publications

References 14 publications

Gastrointestinal bleeding in stroke.

Gastrointestinal bleeding in stroke.

Peptic Disease in Childhood in Asir Province

A Double-Blind Randomized, Controlled Study to Investigate the Efficacy of Cimetidine Given in Addition to Conventional Therapy in the Prevention of Stress Ulceration and Haemorrhage in Patients with Acute Spinal Injury

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